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SEISMIC SCREENING CHECKLIST Reviewer Nama <br />Total Bldg. Sq, Ft. <br />Agehcy Tdtai Lease Sq. Ft.,— <br />L6cat{pn,; <br />.. Hours of Use <br />1 Retrofit'since 1976 <br />No furtherscreening required 1f documentation of retroflt is provided. <br />2 AC <br />Ty <br />a. of 6ullaing A <br />pe of Con'stru'ctlon <br />Tilt-U <br />pre 1933 <br />5 <br />1933 to 1976 <br />u . Fes; ;P m <br />ea .i v 9.^.. 1 <br />Post 1976 <br />�nIaQ... w <br />RiAT <br />Score <br />Masonr <br />10 <br />..:' <br />Reinforced Concrete <br />7 <br />5 <br />1 <br />Wood Frame <br />3 <br />2 <br />1 <br />Steal <br />7 <br />3 <br />1 <br />11 <br />3.Heght:of,l3u1101ilg'.I,!1.S�Griss-;':',,'.,:r_�-:;,:..!, ..�. <br />Max, number of stories allowable for screening Is6, Asslgnonepornt <br />Par story, I.e., f min„ 6max, (1-g) 4 <br />Asaign points as Indlcated forcountias as grouped in a, b, & c below <br />(a) 12 points In Los Angeles, West 1/3 of San Bernardino, 12 <br />Contra Costa, Riverside, Santa Clara, Alameda, Ventura, <br />San Francisco, Marin <br />(b) 0 points In Sonoma, Santa Barbara, San Mateo, 9 g <br />Orange, San Diego, Inyo, San Luis Obispo, Napa, Kern, <br />Monterey, Solano, Humboldt, Mendocino <br />(c) 3 points to all other counties not listed above. 3 <br />6:C'oriflsauraE1an'.(V.ert'id'ati7 <br />t10 <br />�� <br />��A1TR16p �lamam �®® <br />T / J� <br />d <br />5 a 7 90 7 1 7 <br />All other configurations 1 <br />6 Conflguratlon,(Plan Vlaw). <br />END iH L <br />1 3 7 7 7 7 <br />7 Visible Defects <br />Subjective scoring: 10 paints max, assignable for alldefects <br />observed. The following list Is of typical things to look lot <br />a Dry rot; look for water stains on ceiling tiles end walls, <br />b Damaged foundations; look for large cracks and misalignment <br />c Sagging or shifted beams; look for bowing in center, check for <br />position (parallel) relative to other members <br />d Tilted walls or columns <br />e Corrosion of steel; look for rust, flaking, etc. Check for water stains, <br />If Cracks greater than 118" in masonry or concrete <br />g Check for any material that crumbles (wood, plaster, conc., etc) (1.10) <br />TOTAL 28 <br />Total score of 20 orabove requires standard seismic certification. <br />Capy 015eisimu rneekl,abe�h,a�,we <br />80A-291 <br />